Ruth Goldberg is about to turn 99. For the past seven years she has been living at Atria Kew Gardens, an assisted living facility in a historic residential neighborhood near Forest Park.
According to her daughter, Judith Mermelstein of Hillcrest, the facility was chosen, over a period of several months, “by process of elimination. There were four I had considered. One was very chilly. Another was a former hospital and I realized that the dining room had been the morgue. The third has a lot of Chinese and Russian residents and my mother doesn’t speak Chinese or Russian.”
Thus, the decision was made. But no matter how one goes about it, choosing the appropriate assisted living facility for oneself or for a loved one can become one of life’s most daunting experiences.
Making matters particularly complicated is the reality that as the senior population in this country has grown, so, too, have the options for living arrangements available to its members proliferated.
In fact, it was not so long ago that assisted living as it exists today emerged as an alternative on the continuum of care for people for whom independent living is no longer appropriate.
What, exactly, is assisted living? It may best be defined as a philosophy of care and services promoting independence and dignity. It is generally seen as the most viable choice for individuals who are too young to live in a retirement home and are not in need of the around-the-clock medical care provided by a nursing home.
It should be pointed out, as SeniorHomes.com does, that assisted living does not come cheaply. According to the site, the Census Bureau has estimated that the average per-diem rate for assisted living in a private room is between $50 and $120, or about 60 to 70 percent of a similar-sized room in a nursing home.
Several sources of funds are commonly used for paying for assisted living: private funds; long-term care insurance (an umbrella term that covers nursing home care and assisted living care in addition to other medical services); and veterans’ benefits.
SeniorHomes.com indicates that Medicare won’t pay for assisted living care but, in some cases, Medicaid will.
Finances aside, what are some of the considerations that should enter the picture when choosing an assisted living facility?
Dana Jaffe, a longtime resident of Little Neck who has written on the subject, followed her own advice and helped find a facility for her father, one which left him feeling comfortable with the choice he ultimately made.
First, she suggests, “It is best to be informed of the choices before visiting any facilities and to have a list of questions ready when you do choose to visit.”
Jaffe encourages use of the internet to help locate facilities in a desired location. In fact, she suggests, “Read the internet websites of all the facilities in your target area.” Next, according to Jaffe, it is important to “determine the level of assistance/care that your relative needs.”
There are several pointed questions she believes should be answered prior to making a decision. These include:
• How many meals are provided daily? (She recommends asking for a sample menu.)
• Are laundry services provided?
• What is the distance range of transportation to physicians?
• How far is the nearest hospital?
• Is a nurse available on the premises?
• Is the front desk covered 24 hours?
• How can residents handle their shopping, banking and other chores?
• What is the male/female ratio of residents?
• Under what circumstances might a resident no longer be allowed to remain in the facility?
Mermelstein also suggested finding out about visiting hours. She was told at one facility that “we don’t allow anyone to see the residents.”
And providers caution that you should follow up on information posted online, in case some of it is out of date.
The website Agingcare.com recommends that “there’s no better way to get real feedback than by asking the residents themselves.”
It also offers specific questions to look into: Are the grounds well maintained? Are different room and apartment floor plans available? Is there ample closet space, as well as a private kitchen and bathroom? What furniture is included? Are the stairs and hallways well lit? Are exits well marked? Are there fire alarms? How are special dietary needs handled? Are there set dining times? Is there a sit-down restaurant? What fitness facilities are available? Are religious services offered? Are there entrance fees? What other fees are there besides monthly rent? Is the facility state licensed?
Always take a tour
Jaffe strongly encourages taking a tour of a facility under consideration. “You will get a general sense of the resident population’s age and capacities, which will help you and your relative decide if this facility is a good match.”
She cautions, however, “Make no decisions while on a facility tour. It is very helpful to return home, discuss and weigh all the options.”
Types of assisted living
According to SeniorHomes.com, there are three classifications of assisted living facilities. These include basic residences, enhanced residences and special needs residences.
According to the website, the basic residences are geared toward seniors who are medically stable and relatively independent but need some assistance with the activities of daily living. The enhanced residences would be more suitable for seniors with more limiting physical conditions that require assistance with walking or getting out of bed. Special-needs residences are for seniors with Alzheimer’s or dementia.
The site indicates that in New York State, there are approximately 500 assisted living facilities. The average cost, it states, is $3,950 per month, with rates ranging from $1,500 to $9,500, depending on location and other factors.
Assisted living facilities are regulated by the New York State Department of Health and are inspected every 12 to 18 months.
When assisted living is the right move
Experts suggest that there are various signs that could indicate that a relative might need to move into a facility. Among these is the appearance of the skin. Does it feel soft? If not, it could indicate prolonged dehydration, which can have serious consequences. Is the color of the skin normal? Bruising could result from bumping into furniture the individual cannot clearly see.
Other indicators: Can your relative hear you when you speak? Is there food in the refrigerator? Are medications current and being taken regularly?
The website Assisted Living.com adds to the signs to look out for: Is the individual maintaining proper hygiene? Is he or she easily disoriented? Are there word problems? Unopened mail? Spoiled food?
Longtime Queens resident Meryl Weiss Bayer helped her mother-in-law find a place to her liking, choosing Boulevard ALP in Flushing. There, the Holocaust survivor, who is now in her 90s, has her own room, complete with a small kitchenette. She is served three meals a day, which according to the facility’s website, are Glatt kosher.
“They have activities, a library. It’s very nice,” Bayer said.
Although there are nurses on staff, Bayer said, “Five mornings a week we have someone coming in to help her”: a social worker who caters to survivors.
The facility’s website indicates that it has a shul on the premises, as well as a Shabbos elevator. Personal assistance is available for activities of daily living, as are physical and occupational therapy. A medical staff is on the premises, and assistance is offered for medication management. Amenities include daily housekeeping, linen/laundry services, a library, computer room, beauty salon and barber shop.
Another local facility is the Madison York Assisted Living Community, a 226-bed residence located in a seven-story building in Corona, which is one of three facilities that comprise the York Group. In addition to residential services, it offers care management, counseling, advocacy and a wide range of activities. The other facilities in the group are the Madison York Rego Park and Elm York Assisted Living.
According to Barbara Castellano, director of community relations, “The York Group is renowned for providing quality care for decades. So, you can be confident that you’ll receive the professional services you need and the personalized attention you deserve.”
As the search for the right facility is a complex process, Castellano suggests that “ultimately, your decision may come down to the location or “word on the street,” adding that the services provided by the York Group allow “each of our residents to age in place with dignity.”
As Debra Drelich, a social worker who specializes in geriatric care, said in an article in The New York Times, “There is no one right plan for all elders.”
The bottom line for most individuals planning a move to an assisted living facility was summed up by Assisted Living.com., which stresses the importance of making the transition as seamless as possible.